SUBLETTE COUNTY HOSPITAL DISTRICT
NPI 1104410596
Family Medicine in Pinedale, WY
About Sublette County Hospital District NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
SUBLETTE COUNTY HOSPITAL DISTRICT (NPI 1104410596), doing business as Pinedale Medical Clinic, is a healthcare organization registered as a family medicine in Pinedale, Wyoming and active in the NPI registry since February 2021. The organization holds 2 active CLIA laboratory certificates and lists Rex Walk, Chief Executive Officer, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Sublette County Hospital District is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
10Medicare enrollment records show 10 clinicians reassign Medicare billing to Sublette County Hospital District, which bills Medicare for the services they deliver. Of these, 3 practice at this address and 4 within 10 miles. They are listed nearest first.
Clinicians by Medicare Specialty 4
Clinicians, nearest first (10)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA 2
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 53D2327327
Sublette County Hospital District Dba Pinedale Medical Clinic · Pinedale, WYCertificate of Accreditation 53D0520195
Sublette County Hospital District Dba Sublette County Health · Pinedale, WYFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Sublette County Hospital District's NPI number?
The NPI number for Sublette County Hospital District is 1104410596. It was assigned to this organization in the NPPES registry on February 25, 2021. The provider is doing business as Pinedale Medical Clinic.
Where is Sublette County Hospital District located?
Sublette County Hospital District is located at 625 E Hennick St, Pinedale, WY 82941. The listed phone number is (307) 367-4133.
What is Sublette County Hospital District's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Sublette County Hospital District enrolled in Medicare?
Yes. Sublette County Hospital District is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Sublette County Hospital District?
According to the CMS Revalidation Reassignment List (October 2026 release), 10 clinicians in 4 Medicare specialties reassign their Medicare billing to Sublette County Hospital District. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (5), Family Practice (3) and Emergency Medicine (1). Of these, 3 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Sublette County Hospital District hold CLIA laboratory certificates?
Yes. 2 active CLIA laboratory certificates are associated with this NPI under the federal Clinical Laboratory Improvement Amendments program. The certificates are listed in the CLIA Laboratory Certificates section above.
What insurance does Sublette County Hospital District accept?
Health plans from Blue Cross Blue Shield of Wyoming list Sublette County Hospital District as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Sublette County Hospital District was last updated on July 14, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Sublette County Hospital District · NPI 1104410596
Family Medicine organization in Pinedale, Wyoming. Organization record, active in the CMS NPPES registry since February 25, 2021.
## Identity
- **NPI:** 1104410596 (Entity type: Organization)
- **Enumerated:** February 25, 2021
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Also known as:** Pinedale Medical Clinic (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Rex Walk, CHIEF EXECUTIVE OFFICER
## Practice location
- **Address:** 625 E HENNICK ST, Pinedale, WY 82941-5228
- **Phone:** (307) 367-4133 · **Fax:** (307) 459-8576
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 10 clinicians in 4 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (5), Family Practice (3), Emergency Medicine (1); 3 practice at this address and 4 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** July 14, 2026
- **CLIA laboratory certificates:** 2 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1104410596) · Data from the CMS NPPES public registry.